Eczema & Dermatitis & MM Flashcards
What is dermatitis?
inflammation of the skin
How does dermatitis appear?
sore, red, itching skin
What are the two most common types of dermatitis?
Irritant dermatitis - irritant penetrates the outer layer of the skin to invoke a physiological response
Allergic dermatitis - requires sensitisation, once sensitised to an allergen, re-exposure triggers memory T cells to initiate an inflammatory response 24-48 hours after re-exposure
What are symptoms of dermatitis?
- Dry, flaky skin that may be inflamed and have small red spots
- Skin may be broken and weepy and sometimes thickened
- Affected skin may be irritating and extremely itchy
Where are the common affected sites?
- Most commonly affected sites include the nappy area, neck, back of the scalp, face, limb creases, flexures (behind knees and elbows) + back of the wrists
When to refer a pt with dermatitis?
- signs of infection (weeping, crusts, rash spreading)
- severe symptoms e.g. cracked skin, bleeding
- symptoms unresponsive to tx
- no identified cause, not previously diagnosed as eczema
- symptoms lasting longer than 2 weeks
What tx options can be recommended for pts with dermatitis?
- Topical corticosteriods e.g. hydrocortisone, clobetasone suitable for mild-moderate eczema that is not broken and should not be sold for use in children (under 10 years for hydrocortisone, under 12 years for
clobetasone) for maximum 7 days used
max of 15g can be sold at any one time
cant be used on facial skin, the anogenital region or broken or infected skin - Emollients - mainstay of tx for soothing skin, preventing drying and for using as a soap substitute or as bath additives
Name some common OTC preps.
Oilatum Aq cream emulsifying ointment Epaderm Cetraben Doublebase
if the skin is dry to very dry, what tx is best?
ointment
if the skin is mildly dry, what tx is best?
cream
if the skin is broken or weeping, which is best?
water-soluble cream
How much steroid should be applied ?
finger tip unit - tip of the finer down to the first crease
The quantity required for both hands? both arms? Both legs or trunk?
both hands - 15-30g
both arms 30-60g
both legs or trunk 100g
how long after used the steroid can the emollient be applied ?
30 minutes after
on exposure to ultraviolet light, what do our melanocytes do?
increase production of melanin which absorbs both UVA and UVB protecting skin from damage
what is sunburn?
inflammatory response to excessive exposure to ultraviolet light whereby an increase in inflammatory mediators results in capillary vasodilatation and increased capillary permeability
What occurs to the skin when there is melanin production?
epidermal hyperplasia occurs, causing skin to thicken and this provides further protection against the skin
Where is the most common sites of melignant melanoma (MM)?
- in women lower leg
- in men back of the neck
what are risk factors of MM?
multiple moles
those with susceptible sunburn skin types
early childhood exposure to sun
What is the 7 point rule?
Major (scores 2):
change in shape
change in size
change in colour
Minor (scores 1): largest diameter 7mm or more inflammation oozing change in sensation (itch or irritation)
any lesion should be suspected with a score of 3 or more
What is the ABCDE rule ?
A - Asymmetry - irregular in shape
B - Border - irregular border with jagged lines
C - Colour - shades of brown mixed with black, red, pink, white or blush tint
D - Diameter - more than 7mm in diameter
E - Evolution - all of the above has changed with time
When to refer?
facial lesions especially in those over 60
lesions that have become itchy, irritated or are prone to bleeding
Moles changed in shape etc
What acronym is used for avoidance measures?
SMART
SLIP!SLOP!SLAP!SEEK!SLIDE!
What does the acronym SMART stand for?
S - spend time in the shade between 11am to 3pm
M - Make sure you never burn
A - aim to cover up with a t-shirt hat and sunglasses
R - Remember extra care with children
T - Then use factor 15+ sunscreen and four stars
What medicines cause medicine-induced photosensitivity?
- NSAIDS
- Tetracyclines
- chlorpromazine
- Phenothiazines
- amiodarone
cause pruritus and skin rash when the skin is exposure to natural sunlight
